Purpose of review: Pigmented and depigmented ocular fundus lesions (de-POFLs) can be isolated and clinically insignificant, or they may be the hallmark of associated serious systemic disorders such as familial polyposis. The ophthalmologist is often called upon to look for these retinal lesions, or may encounter them in the course of routine examination when appropriate medical referral becomes essential.
Recent findings: The ophthalmoscopic and location differences between grouped pigmentation of the retinal pigment epithelium (bear tracks) and multiple POFLs associated with familial adenomatous polyposis is reviewed. The differential diagnosis, morphology and associations of de-POFLs are also listed and some of the associated genetic conditions are reviewed.
Summary: Familiarity with the morphologic and ophthalmoscopic features of pigmented and de-POFLs is essential for the ophthalmologist so that an exact diagnosis is made and the appropriate workup and referrals initiated.